Unit 1 Flashcards
(347 cards)
1
Q
anatomical position
A
- A person with body erect, feet together, head, eyes and toes directed forward, upper limbs by the side and held so that the palms of the hands face forward
- All terms of direction are defined relative to anatomical position
2
Q
sagittal plane
A
1) Divides body into right and left parts
2) Divides the body in parallel to a median or midsagittal section
3
Q
medial (midsagittal) plane
A
1) cuts through the midline and divides the body into equal right and left sides
4
Q
horizontal/transverse plane
A
1) Divides the body from side to side into top and bottom parts
5
Q
axial plane
A
1) Synonym of horizontal section/plane
6
Q
coronal/frontal plane
A
1) Divides the body at 90 degrees from the median, sagittal and horizontal planes.
2) Partitions the body into a front and back parts
7
Q
anterior/ventral
A
front
8
Q
posterior/dorsal
A
back
9
Q
superior
A
up/above
10
Q
inferior
A
down/below
11
Q
rostral
A
at or near the front end (towards the beak/mouth)
12
Q
cranial
A
superior end/head end
13
Q
caudal
A
inferior end (towards tail end)
14
Q
proximal
A
close to the origin
15
Q
distal
A
away from the origin
16
Q
superficial
A
at or close to the surface
17
Q
deep
A
away from the surface
18
Q
lateral
A
away from midline
19
Q
medial
A
close to midline
20
Q
ipsilateral
A
on same side of body
21
Q
contralateral
A
on opposite side of body
22
Q
unilateral
A
on one side of the body
23
Q
bilateral
A
on both sides of the body
24
Q
flexion
A
reduction in the angle of a joint
25
extension
increase in the angle of a joint
26
abduction
moving a part of the body away from the midsagittal plane
27
adduction
moving a part of the body towards the midsagittal plane
28
rotation
1. Movement of a body part around a superior-inferior axis
2. Medial rotation or lateral rotation
29
pronation
medial rotation of the forearm
30
supination
lateral rotation of the forearm
31
inversion
medial rotation of the sole of the foot
32
eversion
lateral rotation of the sole of the foot
33
somatic structures
structures made of skeletal, voluntary muscle
- body wall and structures that are derived from the body wall (limbs)
34
visceral structures
include smooth muscle, cardiac muscle, glands
include all internal organs of the body
also include the vasculature, arrector pilli muscles, sweat glands, and sebaceous glands
35
skin (epidermis and dermis)
1. Sweat glands and hair (with arrector pili muscles) within the epidermis
2. Unnamed arteries, veins and veins travel through the dermis
3. Cutaneous nerves carry sensory input from the skin and visceromotor output to it
36
subcutaneous layer of the body (AKA superficial fascia)
1. A layer of loose, irregular connective tissue
2. In dissection, look for named cutaneous vessels and nerves here
37
deep fascia layer of the body
1. Striated/Skeletal muscle ensheathed by a layer of dense irregular connective tissue called the epimysium, or deep fascia
2. Deep fascia on outer surfaces of superficial limb muscles forms a fascial sleeve that envelops the entire limb
3. Blood vessels and nerves will typically travel in between deep fascia structures
38
structural joint classification
by type of connective tissue and presence of joint cavity
39
synovial joint classification
a. features space between bones that is encapsulated and filled with fluid; articular surfaces are covered in cartilage; stabilized by ligaments
40
fibrous joint classification
a. bones connected by fibrous connective tissue; no proper cavity
41
cartilaginous joint classification
a. bones connected by cartilage, no proper cavity
42
functional joint classification
by degree of mobility
43
synarthrosis function joint classification
immobile
44
amphiarthrosis joint classification
limited movement
45
diarthrosis joint classification
freely mobile
46
hinge
one degree of freedom; usually flexion-extension
47
pivot
one degree of freedom; rotation around longitudinal axis
48
condyloid a.k.a ellipsoid
two degrees of freedom; curved surface meets dish/cup
49
saddle
two degrees of freedom; functionally similar to condyloid
50
ball and socket
three degrees of freedom; can rotate around long-axis
51
planar a.k.a. gliding
two degrees of freedom; can sometimes rotate a bit in addition to sliding in two axes
52
combining structural and functional classifications
1. All synovial joints are diarthroses
2. Suture – fibrous synarthrosis
a. joints between cranial bones
3. Syndesmosis – fibrous amphiarthrosis
a. interosseous membrane between radius and ulna
4. Symphysis – cartilaginous amphiarthrosis
a. intervertebral discs
5. Synchondrosis – cartilaginous synarthrosis
6. epiphyseal growth plates
53
palpable landmarks
-External occipital protuberance (EOP) skull
-CV2 spinous process
-CV7 vertebral prominens
-TV3 root of scapular spine
-TV7 inferior angle of scapula
-TV12 spinous process & rib 12
-LV4 iliac crest
54
Vertebral column
vertebrae + intervertebral discs + ligaments = vertebral column
function: protect spinal cord, support skull, allow rib muscles and ligaments to attachment
33 vertebrae total
55
cervical vertebrae (CV)
first part of spine, 7 vertebrae, secondary curvature
56
Thoracic vertebrae (TV)
second section of spine, 12 vertebrae, primary curvature
57
lumbar vertebrae (LV)
third section of spine, 5 vertebrae, secondary curvature
58
sacral vertebrae (SV)
fourth section of spine, 5 vertebrae, primary curvature, fused together
59
coccygeal vertebrae (CoV)
fifth section of spine, 3-5 vertebrae, fused together
60
primary curvatures
present at birth, concave anteriorly (kyphotic)
- thoracic and sacral
61
secondary curvatures
develop w/walking, convex anteriorly (lordotic)
- cervical and lumbar
62
hypokyphosis
exaggerated curve of the thoracic section
63
hyperlordosis
exaggerated curve of the lumbar section
64
scoliosis
abnormal lateral curve of the vertebral column
65
vertebral body
anterior portion that supports the weight of the body
66
vertebral arch
posterior portion that protects the spinal cord
- pedicle: two "feet" that connect lamina to the body
-lamina: two flat processes that connect pedicles to spinous process
67
spinous process
one midline posterior projection formed where the two laminae meet
68
transverse processes
two lateral projections from the junction of pedicles and laminae
69
vertebral foramen
opening between the body and arch
- vertebral canal created when vertebrae are stacked
-- spinal cord, meninges, roots of spinal nerves, and vasculature are within the vertebral canal
70
articular processes
projections from near where the pedicles and laminae meet
- superior (2) articulate with the inferior articular processes of the vertebra above it
-inferior (2) articulates with the superior articular processes of the vertebrae bellow it
71
intervertebral foramen
between superior and inferior vertebral notches when vertebrae are stacked
- contains dorsal & ventral nerve roots forming a spinal nerve, and often the dorsal root ganglion
72
typical cervical vertebrae
CV1-CV7
small oval shaped bodies
spinous processes are bifid
transverse foramen within transverse processes for vertebral artery and vertebral vein
transverse processes have short anterior and posterior tubercles with a groove between them and contains spinal nerve
73
CV1 - Atlas
widest cervical vertebra for support of skull directly
typical transverse foramina on transverse processes
superior aspect has a wide groove for the vertebral artery
NO spinous process or body, instead it is an anterior and posterior arch connected by lateral mass
superior articular facets on the lateral mass of CV1 articulate with the occipital condyles of the skull
74
CV2 - axis
strongest cervical vertebra
typical bifid spinous process and transverse foramina
body has a projection, the dens (odontoid process) that is the rotation point of skull
- articulates with CV1 on inside of anterior arch
-dens held in place by the transverse ligament of the atlas
75
typical thoracic vertebrae
heart-shpaed bodies
spinous processes are long and triangular and point obliquely caudal (down)
articulate with ribs at costal facets on the body and transverse processes
articulation also touches the intervertebral disc between vertebrae
superior costal facet matches rib of the same level
76
typical lumbar vertebrae
LV1-LV5
large bodies
short, thick spinous processes that project posteriorly
mammillary process located on superior articular process allows for attachment of multifidus and intertransversarii muscles as well as stabilizes vertebral joints
accessory process is located on posterior surface of the base of transverse processes and is an attachment for intertransversarii muscles
77
sacral vertebrae
articulates with LV5 and the ilium of the pelvis
median sacral crest: fused spinous process of sacral verts
medial (intermediate) sacral crests (2) are between medial sacral crest and lateral margins of the sacrum and end inferiorly as the sacral comu
sacral canal is a continuation of the vertebral canal and ends inferiorly as the sacral hiatus
sacral promontory is an anterior projection of SV1 vertebral body
sacral foramina (anterior and posterior) are four pairs of foramina similar to intervertebral formina of the CV to LV regions
- anterior: contain ventral primary rami of spinal nerves
-posterior: contains dorsal primary rami of spinal nerves
78
coccygeal vertebrae
articulates iwth the sacrum
very small
vertebral arch is incomplete or lacking
serves as attachment point for pelvic floor muscles
79
zygapophyseal (facet) joints
articulations between adjacent vertebral arches (at superior and inferior articular processes and facets)
80
planar synovial joints with a joint cavity are
surrounded by capsular ligaments
81
surface of articular processes/facets are
covered by hyaline cartilage
82
cervical zygapophyseal joints are
transverse for large range of motions for flexion, extension, lateral flexion, and rotation
83
thoracic zygapophyseal joints are
coronal for lateral flexion and rotation, but limited flexion and extension
84
lumbar zygapophyseal joints are
sagittal for flexion & extension, but limited rotation
85
symphyses joints
symphyses are articulations between adjacent vertebral bodies like intervertebral discs
86
intervertebral discs
separate vertebral bodies from one another
- No intervertebral disc between CV1 and CV2
They experience the same compressive weight as vertebral bodies
There are two portions of each intervertebral disc
--annulus fibrosus (brosus) – outer portion of concentric bundles of
--collagen fibers and fibrocartilage
Nucleus pulposus – inner portion is gelatinous with a high water content
87
longitudinal ligaments definition
run the length of the vertebral column to join and strengthen vertebral bodies and intervertebral discs (more on these in a few slides)
Anterior longitudinal ligament (ALL)
Posterior longitudinal ligament (PLL)
88
anterior longitudinal ligament (ALL)
- lies on the anterior surface of vertebral bodies from the occipital bone to the sacrum
- limits excessive extension of the vertebral column and reinforces annulus fibrosus anteriorly
89
posterior longitudinal ligament (PLL)
-lies on posterior surface of vertebral bodies from CV2 to the sacrum (within the vertebral canal)
- broadens/fans out over the intervertebral discs; narrows over the vertebral bodies
- limits excessive flexion of the vertebral column and reinforces annulus fibrosus posteriorly
90
disc rupture
degenerative changes of the annulus fibrosus (brosus) can lead to herniation fo the nucleus pulposus
91
ligamentum flavum
a yellow, strong, but a bit elastic, ligament that attaches from lamina to lamina of adjacent vertebrae on left and right sides – posterior lateral
Each side spans from the midline to the articular processes of that side
Limits flexion and provides postural support of the vertebral column
segments
92
ligamentum nuchae
-Superior extension of the supraspinous ligament from CV7 spinous process to the external occipital protuberance (EOP)
-Serves as attachment point for muscles of the posterior neck
-Limits flexion of the vertebral column
93
supraspinous ligament
-Strong fibrous cord that connects spinous processes of each vertebrae from CV7 to the sacrum
-Limits flexion of vertebral column
94
capsular ligaments
surround synovial zygapophyseal joints (between articular process inferiorly and superiorly)
95
interspinous ligaments
connects adjacent spinous processes
-limits flexion
96
intertransverse ligaments
connects adjacent transverse processes
- limits contralateral flexion
97
hypertension
vertebral fractures and tears of anterior longitudinal ligaments that are reduced by head rest
98
hyperflexion
tears of interspinous ligament
99
craniovertebral joints - atlantooccipital joint
between the superior articular facet of the lateral mass of CV1 and the occipital condyles of the skull
- synovial joint that permits flexion, extension, and lateral flexion of the head
100
craniovertebral joints - atlantooccipital membranes (anterior and posterior)
connects the margins of the foramen magnum and the anterior and posterior arches of CV1
101
craniovertebral joints - atlantoaxial joint
The atlantoaxial joint are articulations between CV1 and CV2
-The skull and CV1 rotate on CV2 as a unit
-Allows for rotational movement, or a pivot, permitting the head to turn from side to side (“no”)
102
Craniovertebral joints – atlantoaxial - lateral joints
between the inferior articular surface of the lateral mass of CV1 and the superior articular facet for the atlas of CV2
103
Craniovertebral joints – atlantoaxial - medial joint
between the dens of CV2 and the anterior arch of CV1
- pivot joint
104
tectorial membrane
the superior continuation of the PLL from the body of CV2 to the occiput
-Covers posterior surface of the odontoid process as well as the apical, alar, and cruciate ligaments
105
crusiform ligament
-A “cross” shaped ligament that consists of two parts: transverse and vertical
-Transverse part is the transverse ligament of the atlas which holds the dens of CV2 against the anterior arch of CV1
-Vertical part runs from the posterior surface of the body of the axis to the anterior margin of the foramen magnum (superior & inferior longitudinal bands)
106
apical ligament
Connects apex of odontoid process to the anterior margin of the foramen magnum
107
alar ligaments
-Extend from the sides of the dens to the medial side of the occipital condyles, on left and right sides
-Check side to side movement of the head
108
What does the vertebral column contain
CNS: spinal cord
PNS: spinal nerve roots
meninges (layers and spaces, coverings)
Cerebrospinal fluid
extradural fat
arteries
venous plexus (veins)
-
109
efferent neurons in somatic nervous system
motor
110
afferent neurons in somatic nervous system
sensory
111
grey matter
cell bodies
112
amount of spinal nerves
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
total: 31 pairs
113
White matter
axonal, myelinated
114
motor pathway
motor cell bodies within ventral horn have motor neurons that send axons out of spinal cord to form ventral root. Axon then travels as a part of the spinal nerve and then through the dorsal primary ramus or ventral primary ramous to reach skeletal muscle
115
sensory pathway
peripheral receptor activation stimulates sensory nerve endings. Information travels from peripheral receptor to peripheral axon in dorsal primary ramus or ventral primary ramus. Then through spinal nerve and dorsal root ganglion. Central projection from sensory neuron in DRG travels within dorsal root to dorsal horn of spinal cord
116
dorsal root
sensory neurons (affert)
117
Ventral root
motor neurons (efferent)
neuronal cell body in ventral horn of the spinal cord
118
spinal nerve proper
dorsal roots (sensory) and ventral roots (motor) come together to form spinal nerve then divides into dorsal primary ramus and ventral primary ramus
119
Primary rami
usually contain both motor and sensory neurons
120
dorsal primary rami
innervate deep back muscles (motor) and skin of the back (sensory)
- medial and lateral cutaneous branches
121
ventral primary rami
supply muscles (motor) and skin (sensory of the lateral cutaneous (side of body) and anterior cutaneous (front of body)
VPR also form plexuses like cervical (c1-4), brachial (c5-t1), lumbar (l1-l4), and sacral (l4-s4)
122
spinal cord segments
area of the spinal cord where roots attach
123
spinal cord roots
exit spinal cord to form spinal nerve
124
spinal nerve proper
exits through intervertebral foramen and represents one spinal cord segment
125
spinal cord rami
branches of spinal nerve
126
spinal cord level
spinal cord segment associated with a single spinal nerve (or its related rootlets, roots, dorsal root ganglion)
127
sensory intervention name
dermatomes
128
motor innervation name
myotomes
129
dermatomes
area of skin supplied by a single spinal cord segment/spinal level/spinal nerve
130
myotomes
ventral horn somatic motor axons from a single spinal nerve (spinal cord level) and the muscle supplied by that nerve
131
vertebral prominins (VP)
spinous process of C7 vertebrae
132
surfaces of scapula body
ventral surface (costal (ribs) surface) and dorsal surface (spine)
133
scapula borders
vertebral (medial), axillary (armpit), superior
134
scapula angles
superior, inferior, and lateral (glenoid fossa (shoulder joint))
135
scapula fossae
dorsal
- supraspinous and infraspinous
ventral
-subscapular
136
scapula landmarks
spine of scapula, coracoid process, acromion process (articulates w/clavicle)
137
skin of back
supplied by DPR, cutaneous (skin) intervention
138
skin of back exceptions
not all spinal nerves have cutaneous components: C1 DRP (suboccitual nerve) is not cutaneous and is motor only
- lower cervical dorsal primary rami may have cutaneous innervation
-L4 and L5 dorsal primary rami: no cutaneous innervation
139
skin on back of head
innervated by C2 DRP (greater occipital nerve) and occipital artery
140
Fasica
sheet/band of fibrous tissue that lies deep to the skin or invests muscles and various body organs
141
superficial fascia
fatty layer of connective tissue deep to the skin
142
deep fasica
dense, organized connective tissue sheet that binds together or "invests" the deep structure
143
thoracolumbar fasica
separates the deep muscles of the back from the superficial muscles of the back
- posterior to the sacrum it is fused to the tendon of the erector spinae muscle
144
muscle origin definition
proximal attachment (more stable), start of muscle
145
muscle insertion definition
distal attachment (more movement), where the muscle goes
146
muscle attachment
attach muscle to bone directly or indirectly through tendons and fascia
- tendons and fasciae are thickening of dense connective tissue in an aggregated bundle or sheet
147
muscle movements
movement is rarely the result of a single muscle contraction it depends on the net actions of contractions from several muscles (groups of muscles)
- synergists, antagonists, fixators
innervation + blood supply = neurovascular bundle
148
trapezius origin, insertion, innervation and blood supply
origin: superior nuchal line, EOP, ligamentum nuchae, c7-T12 Sps
insertion: lateral 1/3 of clavicle, acromion process, spine of scapula
blood supply: superficial branch of transverse cervical vessels
149
trapezius action
upper fibers - elevate scapula
middle fibers - retract scapula
lower fibers - depress scapula
150
trapezius nerve damage
trapezius atrophy, depressed shoulder girdle, loss of scapular stabilization, trapezius weakness
151
latissimus dorsi origin, insertion, innervation and blood supply
origin: SPs T7 sacrum, iliac crest, lower ribs, posterior lamella of thoracolumbar fascia
insertion: floor of intertubercular sulcus on humerus
innervation: thoracodorsal nerve
blood supply: thoracodorsal artery
152
latissimus dorsi action
extend, adduct and medially rotate humerus/arm
153
levator scapulae origin, insertion, innervation, blood supply
origin: c1-C4 Tps
insertion: vertebral border of scapula above spine of scapula
innervation: dorsal scapular nerve, C3 and C4 VPR's
Blood supply: dorsal scapular artery or deep branch of transverse cervical artery
154
levator scapulae action
elevates scapula
155
rhomboid minor origin and insertion
origin: C7-T1 SPs, ligamentum nuchae
insertion: vertebral border of trhe scapula at the root of the spine of the scapula
156
rhomboid major origin and insertion
origin: T2-T5 SPs
insertion: vertebral boarder of the scapula below the spine of the scapula
157
rhomboid innervation and blood supply
innervation: dorsal scapular nerve
blood supply: dorsal scapular artery or deep branch of transverse cervical artery
158
rhomboid minor and major actions
retract scapula, movement of shoulder girdle (clavicle and scapula)
- stabilizers of scapula when other muscle groups are active
159
rhomboid minor, rhomboid major, levator scapulae
all attach to vertebral border of scapula, all share innervation with dorsal scapular nerve and all share blood supply with dorsal scapular artery or deep branch of transverse cervical artery
160
serratus posterior superior origin, insertion, innervation and blood supply
origin: ligamentum nuchae, c7-T3 sps
insertion: rib 2-5
innervation VPR T2-T5
blood supply: intercostal artery
161
serratus posterior inferior origin insertion innervation and blood supply
origin: T11-L3 SPs
insertion: Ribs 9-12
innervation: VPR T9-T-12
blood supply: intercostal artery
162
serratus posterior superior action
elevates ribs (inspiration)
163
serratus posterior inferior action
depresses ribs (expiration)
164
spinotransversales group
superficial back
includes splenius capitis & splenius cervicis
165
erector spinae group
intermediate back
includes iliocastalis, longissimus, & spinalis
166
Transversospinales group
deepest back
includes semispinalis, multifidus, & rotatores
167
splenius capitis origin and insertion
origin: spinous processes of CV7 and upper TV, ligamentum nuchae
insertion: superior nuchal line of occipital bone, mastoid process of temporal bone
168
splenius cervicis origin and insertion
origin: spinous processes of middle TVs
insertion: transverse processes of upper CVs
169
splenius muscles action and innervation
action: extend vertebral column (bilaterally), laterally flex and rotate vertebral column to same/ipsilateral side (unilaterally)
innervation: dorsal primary rami (DPRs) of middle and lower cervical spinal nerves
170
Erector spinae muscles action and innervation
action: extend vertebral column (bilaterally), laterally flex vertebral column (unilaterally)
innervation: dorsal primary rami
171
erector spinae muscles spatial orientation
most medial: spinalis
middle: longissimus
most lateral: illocostalis
172
transversospinales muscles actions and innervations
action: extend vertebral column (bilaterally), laterally flex and rotate vertebral column to opposite contralateral side (unilaterally)
innervation: dorsal primary rami
173
transversospinales muscle segment lengths
semispinalis: 4-6 segment
multifidus: 2-4 segments
rotatores: 1-2 segments
174
semispinalis capitis origin and insertion
origin: transverse processes of lower CV's and upper TV's
insertion: occipital bone
- superficial to semispinalis cervicis
175
Semispinalis cervicis origin and insertion
Origin: transverse processes of upper TVs
Insertion: spinous processes of CVs up to CV2
- deep to semispinalis capitis
176
semispinalis muscles action and innervation
action: extend vertebral column (bilaterally), laterally flex and rotate vertebral coumn to opposite/contralateral side (unilaterally)
Innervation: dorsal primary rami (DPRs)
177
semispinalis muscles are best developed where?
in cervical region
178
Multifidus muscles action and innervation
action: extend vertebral column (bilaterally), laterally flex and rotate vertebral column to opposite/contralateral side (unilaterally)
Innervation: dorsal primary rami
179
multifidus muscles are best developed in...
lumbar region
180
Rotatores muscles action and innervation
action: extend vertebral column (bilaterally), laterally flex and rotate vertebral column to opposite/contralateral side (unilaterally
innervation: dorsal primary rami
181
rotatores muscles are best developed in...
thoracic region
182
obliquus capitis inferior attachment
CV2 spinous process to CV1 transverse process
- muscle of suboccipital triangle
183
obliquus capitis superior attachment
CV1 transverse process to inferior nuchal line of occipital
- muscle of suboccipital triangle
184
Rectus capitis posterior major attachment
CV2 spinous process to inferior nuchal line of occipital
- muscle of suboccipital triangle
185
Rectus capitis posterior minor attachments
CV1 posterior tubercle to inferior nuchal line of occipital
- not a border of suboccipital triangle
186
muscles of suboccipital triangle action and innervation
action: extend head (bilaterally), rotates head to same/ipsilateral side at atlantoaxial joint (unilaterally)
innervation: suboccipital nerve (C1 DPR)
187
Vertebral artery
-inside suboccipital triangle
-ascends through transverse foramen of CV6-CV1
- then travels medially in groove over posterior arch of atlas in suboccipital triangle
supplies brain
- supplies blood to suboccipital triangle
188
suboccipital nerve
- inside suboccipital triangle
- name for C1 dorsal primary ramus
- somatic motor innervation
- emerges in triangle between vertebral artery and CV1
189
Occipital artery
-NOT part of the suboccipital triangle
-branch of external carotid artery
- supplies posterior scalp
190
greater occipital nerve
- NOT part of the suboccipital triangle
- branch of C2 dorsal primary ramus
- somatic sensory innervation
- supplies posterior scalp
191
content of vertebral canal
spinal cord, spinal nerve roots, meninges (connective tissue), cerebrospinal fluid, extradural fat, venous plexuses
192
length of spinal cord
extends from brainstem/foramen magnum to intervertebral disc between LV1 and LV2
193
spinal cord width
thickest in cervical and lumbar regions (corresponding to nerve plexuses to limbs)
194
spinal nerve numbering
Numbering is relative to vertebrae:
-SNs C1-C7 emerge superior to numerically corresponding vertebrae
-Spinal nerve C8 emerges between CV7 and TV1
-SNs T1-Co1 emerge inferior to numerically corresponding vertebrae
195
spinal cord segments
Each SC segment gives off one pair of spinal nerves
Vertebral level of a SC segment does not necessarily correspond to vertebral level where its SNs emerge from vertebral canal, e.g.:
-L1 SC segment – located between TV10 & TV11
-L1 SNs – emerge between LV1 & LV2
196
conus medullaris
-inferior tapering of spinal cord
-end of spinal cord "proper"
197
cauda equina
-bundle of spinal nerve roots within vertebral canal
"horse's tail"
198
anterior spinal artery
-major artery of the spinal cord
- branch of vertebral artery
-unpaired
199
posterior spinal artery
-major artery of the spinal cord
- branches of vertebral artery
- paired
200
venous plexus
valveless network of vessels
- in spinal cord
201
external vertebral venous plexus
external to vertebral column
202
internal vertebral venous plexus
within epidural space of vertebral canal
203
meningeal layers
Dura mater, arachnoid mater, pia mater
204
dura mater
- most superficial layer
- tough
- extends from foramen magnum to coccyx
205
arachnoid mater
- intermediate/middle meningeal layer
- delicate, spider web-like appearance
206
pia mater
-deepest meningeal layer
- adheres directly to spinal cord
- not visible in gross dissection
207
epidural space
- meningeal space external to dura
- contains fat, internal venous plexus
208
subdural space
- meningeal space between dura and arachnoid
- potential space (no contents normally)
209
subarachnoid space
- meningeal space between arachnoid and pia
- contains CSF, blood vessels, and cauda equina
210
Denticulate ligaments
- extension of pia mater
- anchor spinal cord to dura mater
-separate anterior and posterior SC rootlets
211
Filum terminale
extensions of meninges that together anchor spinal cord to coccyx
212
filum terminale internum
-extension of pia mater
- inside dural sac/subarachnoid space
- terminates at end of sac at SV2
213
filum terminale externum
- fused extension of dura and pia maters
- passed through sacral hiatus to coccyx
- A.K.A. "coccygeal ligament"
214
epidural procedure
- Injection of painkillers during labor/childbirth or surgery
-Needle enters vertebral foramen inferior to conus medullaris
-Needle stops in epidural space without penetrating dural sac
215
Lumbar puncture (spinal tap)
-Diagnostic sampling of CSF
-Needle enters vertebral foramen inferior to conus medullaris: to avoid damage to spinal cord
-Needle stops in subarachnoid space after penetrating dura
216
jugular notch level
between TV2/3
217
sternal angle level
at the level of 2nd rib anteriorly and between TV4/5 posteriorly
218
xiphisternal junction
at level TV9
219
Costal arch
lower anterior margin of the chest wall consisting of the costal cartilages of ribs 7-10
220
Clavicle
articulates medially with sternum, and laterally with acromion process
221
Right Clavicle, superior view
-lateral end is concave anteriorly and flattened
- medial end is concave anteriorly and more robust
222
right clavicle, inferior view
groove for subclavius on inferior surface
223
Axilla - definition and boundaries
space between shoulder and chest wall - shaped like a pyramid
- continuous with posterior triangle of the neck through the cervicoaxillary canal
224
Axilla contains
brachial plexus, axillary vessels, lymph nodes, fat
225
Posterior wall of the axilla
formed by subscapularis, teres major, and latissimus dorsi
226
base of axilla
formed by skin and axillary fascia
227
inlet of axilla
bounded by lateral border of first rib, clavicle, and superior border of the scapula
228
medial wall of axilla
formed by serratus anterior muscle on top of ribs
229
anterior wall of axilla
formed by subclavius, pectoralis major, and pectoralis minor muscles and fascia
230
Nipple and Areola level
at 4th intercostal space without breast tissue
231
anterior axillary fold
formed by the lower border of pectoral muscles
232
posterior axillary fold
formed by scapula and associated muscles (e.g. latissimus dorsi)
233
axillary fossa
found between anterior and posterior axillary folds
234
T4 dermatome
skin over the nipple and 4th intercostal space
235
T6 dermatome
skin in the band covering the xiphoid process
236
location of breast
extends superiorly from 2nd to 6th (or 7th) rib inferiorly and medially from sternal to axilla laterally
roughly 2/3 lies on the pectoralis major muscle, and 1/3 on serratus anterior muscle
confined to the superficial fascia and except during pregnancy, consists mostly of fat
237
structure of the breast
mammary glands and associated structures
15-25 lobules each secrete into a lactiferous duct
each duct has a dilation called the lactiferous sinus in which a drop of milk accumulates in a nursing women
ducts open separately into the Nipple
Darkly pigmented areola surrounds the nipple and contains sebaceous glands that secrete a protective lubricant
suspensory ligaments (of cooper) firmly attach breast to the skin
238
lymphatic drainage of the breast
75% drains laterally to axillary lymph nodes, which are then drained by the subclavian lymphatic trunk
25% drains medially to parasternal lymph nodes or to the other breast
239
clavipectoral fascia
runs from clavicle to pectoralis minor
- deep fascia of the pectoral region
240
pectoralis major origin, insertion and innervation
origin: medial part of clavicle, sternum, costal cartilages of ribs 2-5
insertion: crest of greater tubercle
innervation: medial pectoral nerve (C8-T1) and lateral pectoral nerve (C5-7)
241
pectoralis major action
adduction, medially rotation, and flexion of arm at shoulder joint
242
pectoralis minor origin, insertion and innervation
origin: ribs 2-4 or 3-5
insertion: coracoid process of scapula
innervation: medial pectoral nerve (C8-T1)
243
Pectoralis minor action
protracts and depresses scapula
244
subclavius origin, insertion and innervation
origin: junction of first rib and its cartilage
insertion: inferior surface of clavicle
innervation: nerve to subclavius (upper trunk of brachial plexus (C5/C6)
245
Subclavius action
depresses clavicle
246
serratus anterior origin, insertion, and innervation
origin: upper 8th ribs
insertion: vertebral border of scapula
innervation: long thoracic nerve (C5-C7)
247
Serratus anterior action
protracts scapula, rotates scapula to prevent retraction of the scapula and shoulder
248
What does the axillary artery change to at the inferior border of teres major muscle
brachial artery
249
What does the subclavian artery change to at arterial border of first rib
axillary artery
250
axillary artery
the artery that supplies the axillary region
251
subclavian artery
one of the major branches of the aorta (left) pr brachiocephalic trunk (right)
252
Brachial artery terminates by dividing into
radial and ulnar arteries
253
First part of axillary artery
- spans from its origin at lateral border of 1st rib to superior/medial border of pectoralis minor
- The 1st branch of the 1st part is the superior thoracic artery
- superior thoracic artery supplies first two intercostal spaces
254
Axillary artery 2nd part
- Lies deep to pectoralis minor muscle
- 1st branch of the 2nd part is thoracoromial trunk found near superior border of pectoralis minor and quickly divides into four branches
- 2nd branch of 2nd part is the lateral thoracic artery. Found near inferior border of pectoral minor; supplies lower medial aspect of axilla and pectoral region
255
Axillary artery - 3rd part
-spans from inferior border of pectoralis minor muscle to inferior border of teres major muscle
-- subscapular artery is largest branch of axillary artery; branches into scapular circumflex and thoracodorsal arteries
-- anterior humeral circumflex and posterior humeral circumflex arteries encircle the humorous
256
anterior and posterior humeral circumflex arteries wrap around
humerus
257
circumflex and scapular artery wrap around
scapula
258
thoracodorsal artery supplies
dorsal region of thorax
259
superior thoracic artery supplies
first two intercostal spaces (i.e. the superior thorax)
260
lateral thoracic artery supplies
lateral thoracic region
261
Superficial veins
in subcutaneous tissue
independent of named arteries
262
deep veins
are deep to deep fascia )e.g., brachial fasica, pectoral fascia, clavipectoral fascia)
accompanies arteries
are typically paired and wrap around arteries (vena comitantes)
263
basilic vein
found on medial aspect of arm without corresponding artery (bc superficial)
264
axillary vein
boundaries correspond to those of axillary artery (no corresponding)
265
axillary vein
boundaries correspond to those of axillary artery. Formed by brachial and basillic veins. Receives cephalic vein
266
Cephalic vein
pierces clavipectoral fasica in the deltopectoral triangle
267
Deltopectoral triangle
cephalic vein travels in the deltopectoral triangle, pierces clavipectoral fascial to then drain into axillary vein. Deltoid artery runs with the cephalic vein
268
The brachial plexus
formed by the anterior rami of C5-T1 spinal cord levels
269
Formation of brachial plexus
-Roots unite to form trunks in inferior neck
-Roots of brachial plexus pass in between anterior and middle scalene muscles
- each trunk splits into anterior and posterior divisions as they pass deep to clavicle
- division combine or continue to form medial, lateral and posterior cords named based off of relation to 2nd part of axillary artery
-cords give rise to terminal branches
270
subscapular nerve innervates
C5-C6 to supraspinatus and infraspinatus muscles - from superior (upper) trunk - goes through scapular notch
271
Dorsal scapular nerve goes to which muscle/s
to rhomboid muscles - from anterior primary ramus of C5
272
nerve to subclavius
C5-6 - from upper trunk
273
long thoracic nerve
to serratus anterior - from anterior primary rami of C5, 6, 7
274
musculocutaneous nerve innervates
(C5-7) to anterior compartment of arm - piercing coracobrachialis muscle
275
Lateral pectoral nerve
C5-7 to pectoralis major muscle from lateral cord - find it superior/medial to pec minor
276
Medial pectoral nerve
C8-T1 to pectoralis major and minor muscles
- pierces pectoralis minor and continuing on to pectoralis major
277
medial brachial cutaneous nerve (T1) and medial antebrachial cutaneous nerve (C8-T1)
find them running alongside ulnar nerve, but branch to provide cutaneous sensation
278
Ulnar nerve (C8-T1)
major nerve to hand
279
medial and lateral pectoral nerves
named based on which cord they come from, not where they end up anatomically
280
Axillary nerve
C5-6 to deltoid and teres minor muscles
281
radial nerve
C5-8 to all dorsal muscles of upper limb
282
upper subscapular nerve
C5-6 to subscapularis muscle
283
middle subscapular nerve (thoracodorsal nerve)
C7-8 to latissimus dorsi muscle
284
lower subscapular nerve
C5-6 to subscapularis and teres major muscles
285
Medial nerve
C5-8 is the major nerve to anterior forearm (some hand)
286
coracoid process inferior angle vertebral vertebrae
TV7
287
surface anatomy of arm
acromion process, acromioclavicular joint
coracoid process
medial and lateral epicondyles of humerus
olecranon process
tendon of biceps brachii in the cubital fossa
ulnar nerve behind medial epicondyle of humerus
brachioradialis
-
288
C4 dermatome
on shoulder
289
C5 dermatome
lateral/radial side of the arm
290
C6 dermatome
lateral/radial side of the forearm
291
C7 dermatomes
middle three fingers
292
c8 dermatomes
medial/ulnar side of the hand and forearm
293
t1
medial/ulnar side of the forearm and arm
294
T2
ulnar side fo arm and axillary floor
295
medial side of upper limb
a. medial brachial cutaneous nerve joined by intercostobrachial nerve which is
the lateral cutaneous branch of the second intercostal nerve
b. medial antebrachial cutaneous nerve
296
lateral side of upper limb
a. upper lateral cutaneous nerve of arm (branch of axillary nerve)
b. lower lateral cutaneous nerve of arm (branch of the radial nerve)
c. lateral antebrachial cutaneous nerve (continuation of the musculocutaneous
nerve)
-
297
dorsal side of upper limb
a. posterior cutaneous nerve of arm (radial nerve)
b. dorsal cutaneous nerve of forearm (radial nerve)
298
cephalic vein part 2
a. courses from the dorsal venous arch on the dorsum of the hand at the lateral (radial) side
b. ascends the forearm to the anterolateral aspect at the elbow, then
goes to the deltopectoral triangle
c. pierces clavipectoral fascia to join axillary vein
299
basilic vein part 2
a. courses from the dorsal venous arch on the medial (ulnar) side of the dorsum of
the hand
b. ascends to the antero-medial side at the elbow
c. shortly above the elbow the basilic vein pierces the deep fascia to
join the brachial vein and forms the axillary vein
-
300
median cubital vein
a. is formed in front of the elbow
b. connects basilic and cephalic veins
c. separated from the brachial artery and median nerve by the bicipital
aponeurosis
301
humerus
1. head
2. greater and lesser tubercles; intertubercular sulcus
3. anatomical neck versus surgical neck
4. shaft (diaphysis)
5. deltoid tuberosity
6. radial sulcus
7. lateral and medial epicondyles
8. lateral and medial supracondylar lines
9. radial, coronoid, and olecranon fossae
10. capitulum
11. trochlea
302
proximal end of radius
1. head
2. neck
3. radial tuberosity
303
proximal end of ulna
1. olecranon process
2. trochlear notch
3. coronoid process
4. ulnar tuberosity
304
brachial fascia
covers muscles of arm
305
lateral and medial intermuscular septa
separates arm muscles into anterior and posterior compartments
306
deltoid muscle origin, insertion and innervation
origin: lateral 1/3 of clavicle, lateral acromion and spine of the scapula
insertion: on deltoid tuberosity
innervation: axillary nerve
307
teres major muscle origin, insertion and innervation
origin: inferior angle and axillary border of scapula
insertion: crest of lesser tubercle
innervation: lower subscapular nerve
307
supraspinatus muscle origin, insertion and innervation
origin: supraspinatus fossa of scapula
insert: on greater tubercle
innervation: suprascapular nerve
307
deltoid muscle action
abducts the arm
308
teres major action
adducts and medially rotates arm at shoulder joint
309
supraspinatus action
abducts the arm and assists deltoid muscel in its full movement
310
infraspinatus muscle origin, insertion, and innervation
origin: infraspinatus fossa of scapula
inserts: on greater tubercle
innervated: suprascapular nerve
311
infraspinatus action
laterally rotates arm
312
teres minor muscle origin, insertion, and innervation
origin: lateral border of scapula
insertion: greater tubercle
innervation: axillary nerve
313
teres minor action
laterally rotates arm
314
subscapularis muscle origin, insertion and innervation
origin: costal surface of scapula
insertion: lesser tubercle
innervation: upper and lower subscapular nerves
315
subscapularis action
medially rotates and adducts arm
316
quadrangular space formed by
humerus, long head of the triceps muscle, teres major muscle, teres minor muscle,
posterior humeral circumflex vessels and axillary nerve pass through this space
317
triangular space formed by
teres minor muscle, teres major muscle, long head of triceps muscle
branches of scapular circumflex vessel can be seen through the space
318
triangular interval formed by
long head of triceps muscle, lateral head of triceps muscle, teres major muscle
radial nerve and deep brachial vessels seen through the interval
319
coracobrachialis muscle origin insertion
origin: coracoid process
insertion: halfway down medial aspect of humerus
320
coracorachialis action
adducts and flexes arm
321
biceps brachii muscle origin and insertion
origin: supraglenoid tubercle (long head) and coracoid process (short head)
insertion: on radial tuberosity
322
biceps brachii action
flexes shoulder, flexes forearm at elbow and supinates forearm
323
brachialis muscle origin, and insertion
origin: from lower anterior half of humerus
insertion: on ulnar tuberosity
forms the floor of cubital fossa
324
brachialis muscle action
flexes forearm at elbow
325
triceps brachii muscle origin and insertion
origin: long head from infraglenoid tubercle of scapula, medial head lower half of humerus and upper head which is the upper half of the humerus
insertion: on olecranon process of ulna
326
triceps brachii action
extends forearm at elbow and shoulder
327
profund abrachii artery (deep branch artery)
travels with radial nerve then divides into radial collateral artery and middle collateral artery
328
radial collateral artery
runs with radial nerve, anastomoses with radial recurrent artery, anterior to lateral epicondyle between brachioradialis and brachialis muscles
329
middle collateral artery
runs with nerve to anconeus muscle, anastomoses with interosseous recurrent artery behind elbow joint
330
superior ulnar collateral artery:
travels with the ulnar nerve posterior to medial epicondyle
331
inferior ulnar collateral artery
runs anterior to medial epicondyle
332
suprascapular nerve (C5-6)
from upper trunk, courses through scapular foramen deep to the superior transverse scapular ligament, courses under supraspinatus and infraspinatus muscle, innervating both
333
axillary nerve (C5-6)
off posterior cord, travels with posterior humeral circumflex vessel, through quadrangular space, supplying teres minor and deltoid muscle
334
radial nerve (C5-8)
largest branch of plexus, courses with deep brachial vessels in radial sulcus under the triceps brachii and in triangular interval to reach the lateral intermuscular septum, then into lateral wall of cubital fossa, supplies all muscle on dorsal side of arm and forearm
335
musculocutaneous nerve (C5-7)
from lateral cord, passes through or on the
coracobrachialis, supplying it, then passes between biceps brachii and brachialis,
supplying both, and continues as lateral antebrachial cutaneous nerve in company with
the cephalic vein
336
median nerve (c5-8)
rom both medial and lateral cords, travels in
company with brachial artery to cubital fossa, starts anterolateral but ends medial to the
brachial artery, no motor branches in arm, supplies 6 ½muscles in anterior forearm and 5 muscles in hand
337
ulnar nerve (C8-T1)
largest nerve from medial cord, enters posterior compartment of
arm to pass behind medial epicondyle of humerus, supplies 1 ½ muscles in anterior
forearm and intrinsic muscles of hand NOT supplied by median nerve
338
Sternoclavicular joint
a synovial joint between the medial end of the clavicle and the manubrium
B. represents the only bony articulation between the upper limb and the axial
skeleton
C. contains a fibrocartilaginous disk which separates the cavity into two
D. articular capsule surrounds medial end of the clavicle, disk and articular surface of manubrium
E. interclavicular ligament extends from one clavicle to the other strengthens
superior surface of the joint capsule
F. anterior and posterior sternoclavicular ligaments
found on the anterior and posterior surfaces of the capsule, therefore capsule is strengthened
G. costoclavicular ligament - a strong accessory ligament which joins the clavicle to the first rib
H. permits movement in approximately anteroposterior and vertical planes and some
rotation about the long axis of the clavicle
339
Acromioclavicular joint
a plane synovial joint between the lateral end of the clavicle and the medial
surface of the acromion process of the scapula
A. the capsular ligament surrounds the joint and is reinforced by
1. acromioclavicular ligament is small and superior to the joint
2. coracoclavicular ligament is an accessory ligament joining the coracoid process of the
scapula to the undersurface of the clavicle and consists of two portions
a. medial - conoid ligament
b. lateral - trapezoid ligament
340
scapular ligaments
superior transverse scapular ligament
1. converts the superior scapular notch into a foramen for passage of the suprascapular nerve
2. suprascapular vessels pass over the ligament
coracoacromial ligament
1. passes from lateral margin of the coracoid process to the acromion process
341
glenohumeral or shoulder joint
articulation between the glenoid fossa of the scapula and the head of the humerus
1. a ball and socket synovial joint exhibiting the greatest motility and least stability of the
major joints of the body
2. glenoid labrum is a fibrocartilaginous ridge at the margins of the glenoid fossa which
slightly deepens the fossa
major strength of the joint comes from the rotator or muscular cuff
1. subscapularis muscle - anterior
2. supraspinatus muscle - superior
3. infraspinatus muscle - posterior-superior
4. teres minor muscle - posterior
342
transverse humeral ligament
attaches to greater and lesser tubercles of the humerus, bridging
over the intertubercular sulcus; crosses anterior to the tendon of the long head of the biceps
brachii muscle
343
coracohumeral ligament
from coracoid process to greater tubercle of humerus
D. capsule of the joint is lax and attaches to the glenoid margin external to the labrum and to the
anatomical neck of the humerus
1. capsule has three thickenings anteriorly
a. superior glenohumeral ligament - located above the communication between
the joint cavity and the subscapular bursa
b. middle glenohumeral ligament - located immediately below the communication
between the joint cavity and the subscapular bursa
c. inferior glenohumeral ligament - located inferior to the middle glenohumeral
ligament
344
tendon of the long head of the biceps brachii
passes under the transverse humeral ligament
and enters the joint cavity
1. has a covering of synovial membrane
2. originates from the supraglenoid tubercle, blending with the glenoid labrum
345
